Provider Demographics
NPI:1881944254
Name:DAVIS, JANETTE (MA MFT)
Entity type:Individual
Prefix:MS
First Name:JANETTE
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E COLORADO BLVD, SUITE 527
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1919
Mailing Address - Country:US
Mailing Address - Phone:626-577-8303
Mailing Address - Fax:626-577-8303
Practice Address - Street 1:301 E COLORADO BLVD, SUITE 527
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1919
Practice Address - Country:US
Practice Address - Phone:626-577-8303
Practice Address - Fax:626-577-8303
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31316106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist